Boxed Warning (Boxed Warning)
The text describes the use of local anesthetics in obstetrical anesthesia and surgical procedures. It cautions against the use of the 0.75% concentration of sensorcaine, citing reports of cardiac arrest with difficult resuscitation or death during use of bupivacaine for epidural anesthesia in obstetrical patients. It recommends its use only for surgical procedures where a great degree of muscle relaxation and prolonged effects are necessary. It also warns that local anesthetics should only be employed by clinicians who are well-versed in dose-related toxicity and other acute emergencies which may arise from the block being employed. The text further advises caution for patients receiving ocamin oxidase or antidepressants of the tipyine or infpramin spes because of severe hyperanxety.*